This article investigates the impact of a targeted support program for high-potential teaching staff on the formation of a personnel reserve at a medical university. The structure of such a program is outlined, from identifying high-potential employees, evaluating their plans and results by four directions, and providing targeted support. The conducted comparative analysis of statistical data of participants and non-participants showed that the personnel reserve program not only successfully solves the problem of retaining young personnel, but also stimulates their development, allowing the university to form a high-potential human resource.

The hypoxia-inducible factor (HIF) is a key regulator of the cellular response to hypoxia. This factor coordinates adaptation through the activation of genes controlling angiogenesis (VEGF), glucose metabolism (GLUT1, GLUT3), proliferation (IGF-2), pH homeostasis (CA IX), and erythropoiesis (EPO). Although the role of HIF as a marker of hypoxia and a driver of aggressiveness in solid tumors is well-established, its contribution to the pathogenesis of hematological diseases, particularly in the development of clonal hematopoiesis and leukemogenesis, remains poorly understood and controversial. In this literature review, we focus on analyzing the relationship between HIF-1α expression (the most studied isoform) and the disease severity of myelodysplastic syndrome (MDS), the risk of clonal hematopoiesis, and subsequent transformation to acute myeloid leukemia (AML). Special attention is given to the potential mechanisms by which hypoxia and HIF-1α may promote the selective advantage of the dysplastic clone (e.g., through alterations in metabolism, apoptosis, or interaction with the bone marrow stroma) and its malignant progression. The findings highlight the significance for MDS risk stratification and the search for novel therapeutic targets.

This article addresses the problem of body composition analysis. The methods of anthropometric research are reviewed with a focus on their accessibility and accuracy. The advantages of bioelectrical impedance analysis as the most accessible and accurate method are highlighted. The possibility of its use in clinical practice and scientific research is shown. The individual components of the body are described, as well as changes in body composition during aging. The conclusion is made about the importance of establishing relationships between body composition changes and human functional capabilities, as well as various aging types.

Glioblastoma is the most aggressive primary neuroepithelial tumor of the central nervous system, characterized by an exceptionally poor prognosis. Despite the current integrative therapeutic approach, including maximal surgical resection followed by radiotherapy and chemotherapy, the clinical outcome remains unsatisfactory with the median overall survival of patients not exceeding 15 months. A key pathogenetic factor determining therapy resistance and inevitable tumor recurrence is the presence of a population of tumor stem cells (TSCs) in its structure. In this article, the author discusses the development of a new cytoregulatory strategy for glioblastoma treatment based on proteome-personalized molecular targeting, including the suppression of β-catenin in TSCs by drugs capable of passing the blood–brain barrier. This strategy is based on the regulation of the TSC microenvironment by blocking the CXCR4/CXCL12 signaling axis and suppression of the mechanisms that recruit immunosuppressive cells (T-regulatory lymphocytes and myeloid-derived suppressor cells) to the tumor site, which facilitates the restoration of an effective antitumor immune response. The author advances the idea of creating innovative therapeutical preparations based on autologous CD45⁺ cells reactivated ex vivo using exogenous DNA or RNA, which transmit an inflammatory signal to the TSC microenvironment.

We present information on the principles of timely and adequate surgical treatment of duodenal injuries, which can be useful for clinical physicians. Duodenal injuries are relatively rare in clinical practice, which complicates the selection of an optimal surgical treatment method. The method of surgical intervention depends on the localization and extent of the identified injury. In this article, we describe a clinical case of multiple penetrating abdominal wounds, which resulted in multiple perforating injuries of the duodenum D 4 (OIS-III severity according to AIS-4) with subsequent necrosis. During the third operation, in the setting of peritonitis, duodenectomy with preservation of the pancreas head and the hepatopancreatic ampulla was performed. Anastomosis of the loop of the disconnected jejunum with the pancreatic and common bile duct on drains was performed with a favorable outcome. The selection of a surgical treatment method should be made by a surgeon on an individual basis.

Objective. To evaluate the diagnostic and prognostic value of I-FABP (in serum and urine) and fecal calprotectin as biomarkers for the early diagnosis of necrotizing enterocolitis (NEC) in newborns. Materials and methods. A prospective study involving 42 newborns was conducted. The main group included 12 newborns with a confirmed NEC diagnosis. The comparison group included 18 newborns with intestinal symptoms without NEC. The control group consisted of 12 healthy newborns. The levels of I-FABP in serum and urine, as well as fecal calprotectin, were measured in all the subjects. Receiver Operating Characteristic (ROC) analysis was used to assess the diagnostic accuracy of the markers by calculating the area under the curve (AUC), sensitivity, and specificity. Results. Levels of serum I-FABP, urinary I-FABP, and fecal calprotectin in NEC patients were significantly higher than those in the comparison and control groups (p < 0.001). ROC analysis demonstrated high diagnostic value for each biomarker: serum I-FABP – AUC = 0.91; urinary I-FABP – AUC = 0.76; fecal calprotectin – AUC = 0.86. The combination of the investigated markers showed the highest efficacy, with an AUC of 0.93, a sensitivity of 93.5%, and a specificity of 91.7%. Conclusion. Necrotizing enterocolitis is a life-threatening condition, whose early diagnosis remains challenging. The study results confirm the high informativity of I-FABP and fecal calprotectin as biomarkers of intestinal injury. The combination of these markers demonstrates exceptionally high diagnostic accuracy (sensitivity 93.5%, specificity 91.7%), supporting their use in clinical practice to improve the early diagnosis and management of NEC patients.

Objective. To compare the effect of polyhexanide and Trihexylon® on the biofilms formed by carbapenemase-producing K. pneumoniae and P. aeruginosa isolated from patients with orthopedic infection. Materials and methods. Isolation of K. pneumoniae and P. aeruginosa was performed in 2025 in accordance with the internationally-accepted standards of microbiological research. Species identification was performed by MALDI-TOF MS. Susceptibility to antibacterial drugs was determined by EUCAST v.15.0. Carbapenemase genes were detected by real-time PCR. Biofilms of carbapenem-resistant K. pneumoniae and P. aeruginosa were cultivated for 48 h. Subsequently, the wells were treated with 200 μl of 0.2% polyhexanide solution or Trihexylon® for 5, 10, 20, 40 min. The destructive effect of antiseptic compositions was determined by staining the biofilms with 0.1% gentian violet solution followed by their comparison with the control. To determine the effect of the studied antiseptic compositions on sessile bacterial cells, 190 μl of LB medium and 10 μl of an aqueous solution of resazurin were added to each well. Statistical analysis was performed in the GraphPad Prism 9.0 environment. Results. K. pneumoniae and P. aeruginosa produced various types of carbapenemases. All strains included in the study were sensitive to polyhexanide and Trihexylon®, and formed biofilms. Both antiseptic compositions effectively reduced the biomass of formed biofilms of P. aeruginosa and K. pneumoniae. Exposure to Trihexylon® for 5 min had no effective destructive effect on biofilms of the IMP-producing isolate of P. aeruginosa. In comparison, the polyhexanide solution was active following 5 min of exposure. Both compositions demonstrated antibacterial activity against the sessile forms of P. aeruginosa and K. pneumoniae. Conclusion. The results obtained indicate the potential antibiofilm activity of polyhexanide for clinical use. This is of particular importance for orthopedic surgery, where the prevention and treatment of biofilm-related infections are critical. Further studies should focus on optimizing the exposure duration and developing improved irrigation strategies to ensure sufficient antibacterial activity, cytocompatibility, and economic efficiency considering the cost of the preparations.

Objective. To study risk factors in the development of postoperative delirium in ophthalmic patients and to develop pre-operative preventive measures. Materials and methods. A non-randomized cohort prospective observational study was carried out. The control was a retrospective group of patients (medical records) with a diagnosis of senile cataract treated at the Vladivostok Clinical Hospital No 2. from 2020 to 2024. Results. 9304 cataract operations were performed between 2020 and 2024. Of this number, 41 (0.44%) cases of postoperative delirium (PD) were identified. Among them, 8 (0.09%) patients were transferred to an intensive care unit, taking into account the hypertensive type of PD. The patient age ranged from 68.95 ± 11.85 to 70.7 ± 8.85 years. The Charlson Comorbidity Index ranged from 7.5 ± 2.15 to 8.3 ± 1.85, with a prevalence of chronic heart failure, acute cerebral circulation disorder in the anamnesis, chronic obstructive pulmonary disease, smoking, and alcohol abuse. Following the comparison with the control group, an algorithm for managing ophthalmic surgery patients was developed. This algorithm optimizes premedication measures and excludes the use of drugs that may trigger PD. Conclusion. The research has identified demographic (age), anamnestic (comorbidities and harmful habits), clinical (use of narcotic analgesic, benzodiazepine, and anticholinergic drugs) risk factors in PD development. Optimization of the preparation of ophthalmic surgery patients and exclusion of PD trigger drugs at the anaesthetization stage reduce the frequency of PD by 8.7 times.

The dry eye syndrome (DES) is among the most common chronic eye diseases. However, the diagnosis of DES does not include the study of the ocular surface microbiome. Objective. To evaluate the species composition of microorganisms inhabiting the ocular surface of DES patients in the Primorsky Krai Materials and methods. The study involved 229 ophthalmological patients in the Primorsky Krai aged 18–90 years diagnosed with DES (2023–2025). Microorganisms were isolated using the standard microbiological method. The identification of isolated cultures was carried out using MALDI-TOF mass spectrometry (Autobio). Statistical data processing was performed in the MS Excel 2010 software. Results. Microorganisms belonging to 10 genera were identified, with the main being Staphylococcus and Corynebacterium. Bacteria belonging to the Staphylococcus genus ranked first in the structure. This group was represented by 10 species, with coagulase-negative staphylococci (88.9%) being predominant. DES was most often diagnosed in patients aged 60 to 74 years (43.11%). Conclusion. The conducted study confirmed the presence of a diverse bacterial community in DES patients in the Primorsky Krai. The microbiome is represented by a relatively small number of major genera; however, it contains a significant proportion of known pathogens, albeit in a low diagnostic titer. The results obtained suggest further research in this direction.

Objective. To analyze the financial burden of coronavirus infection in hospital settings, taking into account clinical and statistical groups (CSG), as well as an assessment of its costs for 2020–2023. Materials and methods. The calculation of payment for patient treatment was carried out for four CSGs, taking into account the average length of hospitalization. It was 12, 14, 17, and 24 days in cases of mild, average, severe, and extremely severe course of the disease, respectively. The tariff distribution was as follows: 69% to wages, 14% to the purchase of medicines, 13% to additional inventory, and 4% to food. Results. In 2021, the total economic burden comprised 404,810,111.27 RUB. Expenditures on wages amounted to 284,908,611.22 RUB, medicines – 56,673,415.55 RUB, inventory – 52,625,314.43 RUB, food – 10,602,770.07 RUB. Under the total number of cases of 2235 in 2022, the total economic burden amounted to 370,067,971.31 RUB. In this number, wages accounted for 255,346,900.2 RUB, medicines – 51,809,516 RUB, soft inventory – 48,108,836.27 RUB, food – 14,802,718.84 RUB. In 2023, the total number of cases was 2033, and the economic burden amounted to 308,515,244.25 RUB. The share of wages was 212,875,587.75 RUB, medicines – 43,192,148.24 RUB, inventory – 40,106,994.79 RUB, and food – 12,340,613.78 RUB. Conclusion. According to the data obtained, the economic burden of inpatient treatment of patients with confirmed coronavirus infection associated with SARS-CoV-2 in the State Budgetary Healthcare Institution Regional Clinical Hospital No. 2 over three years amounted to 1,083,393,427.14 RUB under the total number of cases in different clinical and statistical groups of 6932.

Objective. To assess the area-specific indicators of morbidity and mortality from malignant neoplasms among the population of the Amur Oblast (Russia) in the period from 2014 to 2023. Materials and methods. Official data of the Oncology Service (forms 35 and 7) and the Federal State Statistics Service were processed using standard statistical software instruments. Results. In 2023, in the Amur Oblast of the Far Eastern Federal District, 3954 new cases of malignant neoplasms were registered, which exceed the number registered in 2014 by 31.3%. In males, the average incidence rate amounted to 312.17 ± 8.40^о/оооо (compared to 293.09 ± 6.47^о/оооо in 2020) per 100,000 population with an increment of 31.0%. In females, this indicator increased to 249.34^о/оооо (compared to 232.35^о/оооо in 2020) with an increment of 23.4%. In the structure of primary morbidity, skin, breast, tracheal, bronchial, lung, and prostate cancers dominated. The number of patients detected through active screening increased to 23.9%, compared to 20.4% in 2014. The ratio of registered patients to newly-detected cases (cohort accumulation index) increased to 6.1, compared to 5.9 in 2014. The number of patients with stages I-II of malignant neoplasms increased to 56.2%, compared to 52.0% in 2014. Along that, the number of patients with advanced forms of tumor process decreased to 22.4%, compared to 25.3% in 2014. The average value of the statistical indicator of mortality in males amounted to 182.02 ± 3.74 ^о/оооо (compared to 182.76 ± 3.50 ^о/оооо in 2020) per 100 000 population, being higher than in females (92.61 ± 1.03 ^о/оооо and 93.43 ± 0.90 ^о/оооо, respectively). Tumors of trachea, bronchus, and lung, breast, colon, and stomach were leading in the structure of total mortality. Conclusion. Insufficient number of oncology specialists, insufficiently active screening of patients to detect early stages of the disease, ineffective work of primary healthcare units to treat background and precancerous diseases – all these factors are obstacles to improving the quality of healthcare for cancer patients in accordance with the requirements of modern medicine.

Objective. A comparative analysis of the functional outcomes of toric intraocular lens (IOL) implantation with the mechanism of wavefront formation during surgical correction of aphakia in patients after penetrating keratoplasty (PKP). Materials and methods. The prospective study included 65 eyes (65 patients) with a history of PKP who underwent cataract surgery. In group 1 (34 patients, 34 eyes), monofocal thoric IOL AcrySof IQ Toric was implanted. In group 2, toric IOL with wave front formation mechanism AcrySof IQ Vivity (31 patients, 31 eyes) was implemented. Results. In group 2, during the follow-up period of up to 6 months, the mean error of the spherical equivalent refraction (SE) from the expected result was 1.22 ± 0.875. In group 2, this value was significantly lower, 0.76 ± 0.582. No statistically significant difference was found between the mean values of the subjective cylindrical component in both study groups. Patients in group 2 also demonstrated a smoother defocus curve. Conclusion. Due to its design features, IOL with the mechanism of wavefront formation enables the achievement of a reliably smaller spherical equivalent refraction, a more accurate target refraction, and, accordingly, an optimal uncorrected visual acuity.

The article presents a clinical case of endoscopic stenting of the bile and pancreatic ducts in a patient with pancreatic head cancer complicated by obstructive jaundice. The anatomical and functional characteristics of the hepato-biliary-pancreatoduodenal area, which determine the shared embryological origin, blood supply, innervation, and lymphatic drainage of organs therein, are described. The diagnostic challenges associated with the absence of specific symptoms in the early stages of tumor growth in pancreatic head cancer are outlined. The pathophysiological mechanisms of biliary hypertension due to tumor compression of the distal common bile duct are discussed. The stages of clinical and instrumental evaluation and the algorithm of minimally invasive palliative intervention with plastic stent placement are detailed. The results confirm the effectiveness of endoscopic retrograde cholangiopancreatography in restoring the patency of the bile and pancreatic ducts, reducing bilirubin levels, and stabilizing the patient’s general condition. The case underscores the importance of early instrumental intervention in biliary tract obstruction associated with pancreatic tumors.

The growing number of civil cases initiated on claims for improper provision of medical care in the field of orthopedic dentistry is associated with an increase in the number of complications, which can result in the development of serious pathologies. Such situations trigger conflict situations and negatively affect the quality of life of patients, thus entailing the onset of professional responsibility of medical specialists. Legal investigation of civil cases to hold dental practitioners accountable for improper provision of medical care (services) in the field of orthopedic dentistry is based on the results of forensic medical examinations.
Numerous issues related to legal investigation of patients’ claims against dental institutions and dental practitioners remain unresolved. Thus, there is a lack of evidence-based, objective criteria for assessing professional errors and defects in dental care. In addition, there are no effective methods for analyzing the therapeutic and diagnostic process in forensic medical practice, which makes analysis of individual clinical cases rather problematic.
This article presents a clinical case with detailed information about the clinical condition of existing teeth, fixed and removable dentures, characteristics of their position in the oral cavity, defects in fixation and stabilization of dentures. A comprehensive analysis of the possible use of existing removable and non-removable dental structures for full-fledged chewing function and their aesthetic condition is carried out. Significant errors and shortcomings in the planning, manufacturing, and fixation of removable and non-removable dentures are identified.

A clinical case of a young female patient with secondary open-angle glaucoma associated with the Radius–Maumenee syndrome is presented. Over several years, structural and functional parameters remained stable under combined hypotensive therapy, despite persistent variability in intraocular pressure (IOP). During a routine follow-up visit, the patient reported a decrease in contrast sensitivity and the appearance of a veil in front of the eye. Additional diagnostic examinations revealed signs of glaucoma progression, prompting the decision to perform a non-penetrating deep sclerectomy (NPDS) to achieve a target IOP and stabilize optic neuropathy. In this article, we present our clinical experience in the observation and surgical management of secondary glaucoma in the setting of idiopathic dilatated episcleral veins, thus contributing to the development of a feasible treatment algorithm for such patients.

Objective. This article presents a clinical case of multifocal vasoproliferative tumor (VPT) of the retina and its successful treatment. In March 2020, a 28-year-old man with progressive deterioration of vision in the left eye referred to the Khabarovsk Branch of Fyodorov Eye Microsurgery Federal State Institution. Vis = OD 1.0; OS = 0.1 n/c. Anterior-posterior axis: OD = 23.11 mm, OS – 22.61 mm. Intraocular pressure (IOP): OD = 18 mm Hg, OS = 16 mm Hg. In the macular area of the left eye, high retinal edema and isolated deposits of hard retinal exudates were determined. In the equator and periphery, confluent fields of deposits of hard exudates with areas of capillary vascular lacunae with massive exudation were observed. Optical coherence tomography detected a high macular edema with detachment of the pigment and neuroepithelium. B-scanning of the vitreous cavity found no neoplasms of the eye choroid. The diagnosis of vasoproliferative tumor of the retina was established. An intravitreal Ozurdex implant was injected in the left eye. One month later, moderate reduction of macular edema and the subretinal fluid layer occurred. At the second stage, an incomplete panretinal laser coagulation of the retina was performed. Two weeks later, transpupillary thermotherapy (TTT) of the VPT localization zones was performed as the main treatment stage. One month later, a significant reduction in edema and the formation of fibrosis of the VPT were observed. The best-corrected visual acuity (BCVA) of the left eye increased significantly – to 0.9. The IOP level was 19 mm Hg. Three months after TTT, the BCVA of the left eye was 1.0. In the macular area, all VPT fragments were subject to fibrosis; in the parafoveal area, flat detachment of the neuroepithelium, up to 20 μm, and isolated hard exudates remained. Thenanatomical structure of the macular area was restored.

On October 24, 2025 LYUDMILA NIKOLAEVNA KATSUK, Cand. Sci. (Med.), Assoc. Prof., Department of Human Anatomy, Pacific State Medical University, celebrates her 80th birthday and 50 years of teaching activity.